In a new video, Emmy-nominated actress Cheryl Hines holds up a mimosa as she toasts to being “50 and fabulous” with a group of girlfriends during brunch.

She then tells her friends she got a tattoo, which she admits hurt and the conversation quickly turns into one about a taboo topic — painful sex after menopause.

One friend says, “I expected hot flashes. I did not expect this,” while another chimes in, “Lately it feels like sandpaper down there.”

The women laugh at the comparison and continue on with their talk.

This isn’t footage from Hines’ real life, however. The scenario takes place in a video that’s part of a new campaign launched by AMAG Pharmaceuticals called Painfully Awkward Conversations.

The campaign aims to speak to women 50-years old and over who are experiencing painful sex due to menopause, a condition called vulvar and vaginal atrophy (VVA). The condition affects approximately 50 percent of postmenopausal women in the United States.

As a spokesperson for the campaign, Hines hopes to empower women to talk about their symptoms.

“When I started talking to my friends about this campaign and asking them if I should get involved, they all said ‘yes.’ I realized then that a lot of women have this condition or are concerned with it, so being able to start a conversation and to let women know they should definitely talk to each other, or their healthcare provider if they are having issues, is important to me,” Hines told Healthline.

According to the North American Menopause Society, the average age of menopause for women in North America is about 51.

After menopause, hormonal changes can lead to VVA which causes a variety of physical changes to the vagina, such as the loss of vaginal tissue, lubrication, and flexibility. These changes can also cause dryness, irritation, frequent urination, and painful sex.

While many women are aware that hot flashes and night sweats are symptoms of menopause, Dr. Marla Shapiro, family medicine and menopause expert, says data shows that 62 percent of postmenopausal women surveyed were not familiar with VVA. Of those who knew of the condition, half only became aware of it after they experienced symptoms.

“Of the 32 million women who are suffering from [VVA], 50 percent of them are afraid to have sex and will make excuses not to have sex. Another 25 percent think they’re never going to have sex again, and less than 7 percent of these women are treated with safe and effective therapies,” Shapiro told Healthline. “We’re not getting the message out that there are options.”

Shapiro joined the campaign along with Hines in hopes of getting women to recognize the condition, talk about it, and most importantly, get treatment for it.

“We know that when the Women’s Health Initiative came out over a decade ago, women became very fearful of hormones in general and it mistakenly led women to believe that there are no safe options for them as they go through the transition of perimenopause and menopause,” said Shapiro.

Some women can experience a progressive loss of estrogen, and may be three or four years into menopause before experiencing pain during sex, she notes.

“They may think that their symptom is not a part of menopause and believe it’s just part of getting old,” Shapiro said, pointing out that’s exactly the wrong message women should be getting. “The message needs to be that you can empower yourself to ask about it. Maybe if you talk to your friends and realize you’re not the only one, that may make you feel a little more comfortable. Yes, have a little humor about it, but also believe enough in yourself to get the information you need.”

This is the basis behind Hines’ campaign video.

“One of the hardest things about this [condition] is, a lot of time, women feel like it’s only happening to them so it’s hard for them to bring it up,” Hines said. “If you feel like you’re alone and it’s unusual, it’s hard to talk about, but if you know that other people are experiencing it, I think it makes the conversation easier.”

She points to other conversations women often have during earlier stages of their lives, such as puberty, pregnancy, and childbirth.

“Women should feel just as comfortable talking about this as we do about having babies and getting married and other events in our lifetime,” Hines said. “This is just another natural part of life.”

Shapiro wants all women to know that they have the right to have sex that’s not painful.

“If you don’t get information about what your options are, not only does it affect your physical health, but also your emotional health, your self-esteem, and your partner intimacy,” she said.

She suggests talking to your healthcare provider about available safe and effective treatment options, such as estrogen, non-estrogen, and local therapies.

“Make it part of your agenda. Your healthcare provider may be so concerned about your cholesterol and blood pressure and your heart, that asking you about painful sex doesn’t even come up,” Shapiro said. “If it’s not on your own agenda to bring up, and your healthcare provider doesn’t bring it up, it’s a conversation that’s never going to happen. We want this to be as important as men’s sexual health.”

As a woman in her 50s, this sentiment resonates with Hines.

“[Being with your doctor] is a time when you have a private place and can talk about anything. Yet, women are still afraid to bring it up. If, at the very least, I am empowering women to bring this conversation up with their friends or healthcare providers, then I feel great about that because women shouldn’t be having painful sex if they can avoid it,” she said.

And when all else fails, turning to humor to give you the courage to speak up, may be just what you need.

“When you can interject humor into a situation, it makes everyone feel a little more comfortable and it makes people feel at ease. So, it always feels like a good way to go,” Hines said.

Cathy Cassata is a freelance writer who specializes in stories around health, mental health, and human behavior. She has a knack for writing with emotion and connecting with readers in an insightful and engaging way. Read more of her workhere.